HealthcareCrossing Jobs

Commercial Medical Director - Work At Home - USA-MO-Springfield

Mon, 26 Jun 2023 00:00:00 CDT

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of...

Director, National Medicaid Care Management Strategy and Practice - USA-MO-Springfield

Mon, 26 Jun 2023 00:00:00 CDT

Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. T...

Head of Primary Care Recruiting, Primary Care Organization - USA-MO-Springfield

Wed, 24 Aug 2022 00:00:00 CDT

Description As the Head of Primary Care Recruiting in Humana's Primary Care Organization, you will be responsible for developing and engaging your team and educating the business around the Talent Ac...

RN Case Manager - Telephonic Nurse 2 - Complex Case Management Program (Remote) - USA-MO-Springfield

Fri, 07 Apr 2023 00:00:00 CDT

Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding mem...

Manager, Care Management Social Services-WAH Nationwide - USA-MO-Springfield

Sat, 06 May 2023 00:00:00 CDT

Job Information Humana Manager, Care Management Social Services-WAH Nationwide in Springfield Missouri Description Job Description Summary The Manager, Care Management leads teams of social work and s...

Associate Director of Documentation and Inpatient Coding, Payment Integrity - REMOTE US - USA-MO-Springfield

Wed, 06 Apr 2022 00:00:00 CDT

Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fr...

Manager, Fraud and Waste-Remote US - USA-MO-Springfield

Sat, 23 Apr 2022 00:00:00 CDT

Job Information Humana Manager, Fraud and Waste-Remote US in Springfield Missouri Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. T...

Vascular Surgery Advanced Practitioner - Mercy Hospital Springfield - USA-MO-Springfield

Sat, 28 May 2022 00:00:00 CDT

Vascular

Nurse Practitioner II - Radiation Oncology - Springfield, MO - USA-MO-Springfield

Mon, 04 Jul 2022 00:00:00 CDT

Radiation Oncology

RN Case Manager - Telephonic Nurse 2 -Compact Licensure Required (Remote) - USA-MO-Springfield

Thu, 21 Jul 2022 00:00:00 CDT

Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding memb...

Manager, Medicare Risk Adjustment - Remote - USA-MO-Springfield

Thu, 21 Jul 2022 00:00:00 CDT

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medi...

Commercial Medical Director - National Team - Work From Home - USA-MO-Springfield

Sat, 30 Jul 2022 00:00:00 CDT

Nurse Practitioner IV or Physician Assistant IV - Vascular Surgery - Springfield, MO - USA-MO-Springfield

Sun, 09 Oct 2022 00:00:00 CDT

Vascular Surgery

Director, State Public Policy - USA-MO-Springfield

Mon, 24 Oct 2022 00:00:00 CDT

Job Information Humana Director, State Public Policy in Springfield Missouri Description The Director of State Public Policy role resides in Humana's Corporate Affairs department and is charged primar...

Physician Assistant - Endocrinology - Springfield, MO - USA-MO-Springfield

Mon, 24 Oct 2022 00:00:00 CDT

Endocrinology

Director, Medicaid Strategic Solutions - USA-MO-Springfield

Wed, 02 Nov 2022 00:00:00 CDT

Job Information Humana Director, Medicaid Strategic Solutions in Springfield Missouri Description Humana Medicaid is seeking exceptional candidates to join our Medicaid Product Strategy & Optimization...

AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership - USA-MO-Springfield

Sun, 18 Dec 2022 00:00:00 CST

Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Springfield Missouri Description The Healthcare Quality Reporting & Improvement (HQRI) organization is see...

Behavioral Health Medical Director - USA-MO-Springfield

Fri, 23 Dec 2022 00:00:00 CST

Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive cl...

AVP, Stars and Risk Adjustment National Medical Director - USA-MO-Springfield

Mon, 01 May 2023 00:00:00 CDT

Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Springfield Missouri Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a tale...

Senior Innovation Portfolio Strategy Professional - USA-MO-Springfield

Tue, 13 Jun 2023 00:00:00 CDT

Job Information Humana Senior Innovation Portfolio Strategy Professional in Springfield Missouri Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideatio...